Comparison of the Polar V800 and the Garmin Forerunner 230 to Predict V̇o2max.

ABSTRACT: Snyder, NC, Willoughby, CA, and Smith, BK. Comparison of the Polar V800 and the Garmin Forerunner 230 to predict V̇o2max. J Strength Cond Res 35(5): 1403-1409, 2021-The purpose of this study was to compare maximal oxygen consumption (V̇o2max) values (Amax) with predicted V̇o2max values obtained from the Polar V800 (PV800) and the Garmin Forerunner 230 (GF230) to determine whether the accuracy of these estimates differs between sexes. The PV800 predicts V̇o2max based on resting heart rate (HR). The GF230 predicts V̇o2max based on a 10-minute, self-paced outdoor run. Subjects consisted of 22 women and 22 men. After a 10-minute supine rest, predicted V̇o2max (Pmax) values from the PV800 were measured during a 5-minute supine rest. Subjects then completed a treadmill V̇o2max test to determine Amax. Within 48 hours of obtaining Amax, individuals completed a 10-minute, self-paced outdoor run using the GF230 to predict V̇o2max (Gmax). A 2-way (watch vs. sex) analysis of variance was used to determine whether there were differences between predicted V̇o2max and Amax between sexes. A significant interaction between HR monitors and sex was found (p = 0.007). Follow-up analysis showed that in men, Pmax was significantly overestimated compared with Gmax (3.87 ± 1.53 ml·kg-1·min-1, p = 0.013). Bland-Altman plots revealed large random errors that ranged from 6.6 to 16.4 ml·kg-1·min-1 with the PV800 having larger errors than the GF230. The results of this study indicate that the GF230 can provide an accurate estimate of V̇o2max in both sexes. The PV800 can provide an accurate estimate of V̇o2max for women but not men. Estimates of V̇o2max from the both devices should be used with caution because of the large random error associated with them.

Physical activity and academic achievement across the curriculum (A + PAAC): rationale and design of a 3-year, cluster-randomized trial.

BACKGROUND: Improving academic achievement and reducing the rates of obesity in elementary school students are both of considerable interest. Increased physical activity during academic instruction time during school offers a potential intervention to address both issues. A program titled "Physical Activity Across the Curriculum" (PAAC) was developed in which classroom teachers in 22 elementary schools were trained to deliver academic instruction using physical activity with a primary aim of preventing increased BMI. A secondary analysis of data assessed the impact of PAAC on academic achievement using the Weschler Individual Achievement Test-II and significant improvements were shown for reading, math and spelling in students who participated in PAAC. Based on the results from PAAC, an adequately powered trial will be conducted to assess differences in academic achievement between intervention and control schools called, "Academic Achievement and Physical Activity Across the Curriculum (A + PAAC)." METHODS/DESIGN: Seventeen elementary schools were cluster randomized to A + PAAC or control for a 3-year trial. Classroom teachers were trained to deliver academic instruction through moderate-to-vigorous physical activity with a target of 100+ minutes of A + PAAC activities per week. The primary outcome measure is academic achievement measured by the Weschler Individual Achievement Test-III, which was administered at baseline (Fall 2011) and will be repeated in the spring of each year by assessors blinded to condition. Potential mediators of any association between A + PAAC and academic achievement will be examined on the same schedule and include changes in cognitive function, cardiovascular fitness, daily physical activity, BMI, and attention-to-task. An extensive process analysis will be conducted to document the fidelity of the intervention. School and student recruitment/randomization, teacher training, and baseline testing for A + PAAC have been completed. Nine schools were randomized to the intervention and 8 to control. A random sample of students in each school, stratified by gender and grade (A + PAAC = 370, Control = 317), was selected for outcome assessments from those who provided parental consent/child assent. Baseline data by intervention group are presented. DISCUSSION: If successful, the A + PAAC approach could be easily and inexpensively scaled and disseminated across elementary schools to improve both educational quality and health. FUNDING SOURCE: R01- DK85317. TRIAL REGISTRATION: US NIH Clinical Trials, http://NCT01699295.

A 6-month trial of resistance training with milk supplementation in adolescents: effects on body composition.

Fluid milk consumed in conjunction with resistance training (RT) provides additional protein and calcium, which may enhance the effect of RT on body composition. However, the literature on this topic is inconsistent with limited data in adolescents. Therefore, we examined the effects of a supervised RT program (6 mo, 3 d/ wk, 7 exercises, 40-85% 1-repetition maximum) with daily milk supplementation (24 oz/day, one 16-oz dose immediately post-RT) on weight, fat mass (FM), and fat-free mass (FFM) assessed via dual-energy X-ray absorptiometry (baseline, 3 mo, 6 mo) in a sample of middle-school students who were randomly assigned to 1 of 3 supplement groups: milk, isocaloric carbohydrate (100% fruit juice), or water (control). Thirty-nine boys and 69 girls (mean age = 13.6 yr, mean BMI percentile = 85th) completed the study: milk n = 36, juice n = 34, water n = 38. The results showed no significant differences between groups for change in body weight (milk = 3.4 ± 3.7 kg, juice = 4.2 ± 3.1 kg, water = 2.3 ±2.9 kg), FM (milk = 1.1 ±2.8 kg, juice = 1.6 ± 2.5 kg, water = 0.4 ±3.6 kg), or FFM (milk = 2.2 ± 1.9 kg, juice = 2.7 ± 1.9 kg, water = 1.7 ± 2.9 kg) over 6 mo. FFM accounted for a high proportion of the increased weight (milk = 62%, juice = 64%, water = 74%). These results from a sample of predominantly overweight adolescents do not support the hypothesis that RT with milk supplementation enhances changes in body composition compared with RT alone.

Comparison of a reduced carbohydrate and reduced fat diet for LDL, HDL, and VLDL subclasses during 9-months of weight maintenance subsequent to weight loss.

OBJECTIVES: This study compared LDL, HDL, and VLDL subclasses in overweight or obese adults consuming either a reduced carbohydrate (RC) or reduced fat (RF) weight maintenance diet for 9 months following significant weight loss. METHODS: Thirty-five (21 RC; 14 RF) overweight or obese middle-aged adults completed a 1-year weight management clinic. Participants met weekly for the first six months and bi-weekly thereafter. Meetings included instruction for diet, physical activity, and behavior change related to weight management. Additionally, participants followed a liquid very low-energy diet of approximately 2092 kJ per day for the first three months of the study. Subsequently, participants followed a dietary plan for nine months that targeted a reduced percentage of carbohydrate (approximately 20%) or fat (approximately 30%) intake and an energy intake level calculated to maintain weight loss. Lipid subclasses using NMR spectroscopy were analyzed prior to weight loss and at multiple intervals during weight maintenance. RESULTS: Body weight change was not significantly different within or between groups during weight maintenance (p>0.05). The RC group showed significant increases in mean LDL size, large LDL, total HDL, large and small HDL, mean VLDL size, and large VLDL during weight maintenance while the RF group showed increases in total HDL, large and small HDL, total VLDL, and large, medium, and small VLDL (p<0.05). Group*time interactions were significant for large and medium VLDL (p>0.05). CONCLUSION: Some individual lipid subclasses improved in both dietary groups. Large and medium VLDL subclasses increased to a greater extent across weight maintenance in the RF group.

Weight loss-induced alterations in serum markers of bone turnover persist during weight maintenance in obese men and women.

OBJECTIVE: Moderate weight loss alters bone turnover and reduces bone mineral density in overweight men and women. However, it is not known whether bone turnover is normalized during weight maintenance postweight loss. Thus, the objective of the present study was to examine changes in serum bone turnover markers during 9 months of weight maintenance following weight reduction on a very low-energy diet (VLED) in obese men and women. METHODS: Thirty-seven men (n = 13) and women (n = 24) aged 50 +/- 9.8 years underwent 3 months of weight reduction on a VLED ( approximately 500 kcal/d) followed by 9 months on either a low-carbohydrate or low-fat weight maintenance diet ( approximately 1600 kcal/d). Concentrations of osteocalcin (OC) and C-terminal peptide of type I collagen (CTX) in serum were measured using enzyme-linked immunosorbent assay at baseline and at months 3, 6, and 12. Serum parathyroid (PTH) concentrations were measured using a chemiluminescent immunoassay at all 4 time points. Data were analyzed using a 3-factor-repeated measures analysis of variance. RESULTS: Average weight loss was 19% +/- 3% and, during the 9-month weight maintenance period, average weight gain was approximately 3%, with no differences due to diet composition. Serum concentrations of OC and CTX significantly increased after weight reduction and remained elevated during weight maintenance. Serum PTH was reduced after weight loss. Percent changes in OC and CTX were correlated during weight maintenance (r = -0.437, p = 0.008), but not during weight loss. Percent changes in CTX and body weight were negatively correlated during weight loss (r = -0.474, p = 0.003) and maintenance (r = -0.455, p = 0.006). CONCLUSIONS: Weight loss induced via a VLED may result in an imbalance between bone formation and resorption and accelerate remodeling. The deleterious effect of energy restriction on bone remodeling rate appears to persist during weight maintenance.

Physical Activity Across the Curriculum (PAAC): a randomized controlled trial to promote physical activity and diminish overweight and obesity in elementary school children.

BACKGROUND: Physical Activity Across the Curriculum (PAAC) was a three-year cluster randomized controlled trial to promote physical activity and diminish increases in overweight and obesity in elementary school children. METHODS: Twenty-four elementary schools were cluster randomized to the Physical Activity Across the Curriculum intervention or served as control. All children in grades two and three were followed to grades four and five. Physical Activity Across the Curriculum promoted 90 min/wk of moderate to vigorous intensity physically active academic lessons delivered by classroom teachers. Body Mass Index was the primary outcome, daily Physical activity and academic achievement were secondary outcomes. RESULTS: The three-year change in Body Mass Index for Physical Activity Across the Curriculum was 2.0+/-1.9 and control 1.9+/-1.9, respectively (NS). However, change in Body Mass Index from baseline to 3 years was significantly influenced by exposure to Physical Activity Across the Curriculum. Schools with > or =75 min of Physical Activity Across the Curriculum/wk showed significantly less increase in Body Mass Index at 3 years compared to schools that had <75 min of Physical Activity Across the Curriculum (1.8+/-1.8 vs. 2.4+/-2.0, p=0.02). Physical Activity Across the Curriculum schools had significantly greater changes in daily Physical activity and academic achievement scores. CONCLUSIONS: The Physical Activity Across the Curriculum approach may promote daily Physical activity and academic achievement in elementary school children. Additionally, 75 min of Physical Activity Across the Curriculum activities may attenuate increases in Body Mass Index.

Physical activity across the curriculum: year one process evaluation results.

BACKGROUND: Physical Activity Across the Curriculum (PAAC) is a 3-year elementary school-based intervention to determine if increased amounts of moderate intensity physical activity performed in the classroom will diminish gains in body mass index (BMI). It is a cluster-randomized, controlled trial, involving 4905 children (2505 intervention, 2400 control). METHODS: We collected both qualitative and quantitative process evaluation data from 24 schools (14 intervention and 10 control), which included tracking teacher training issues, challenges and barriers to effective implementation of PAAC lessons, initial and continual use of program specified activities, and potential competing factors, which might contaminate or lessen program effects. RESULTS: Overall teacher attendance at training sessions showed exceptional reach. Teachers incorporated active lessons on most days, resulting in significantly greater student physical activity levels compared to controls (p < 0.0001). Enjoyment ratings for classroom-based lessons were also higher for intervention students. Competing factors, which might influence program results, were not carried out at intervention or control schools or were judged to be minimal. CONCLUSION: In the first year of the PAAC intervention, process evaluation results were instrumental in identifying successes and challenges faced by teachers when trying to modify existing academic lessons to incorporate physical activity.

Physical activity across the curriculum (PAAC): rationale and design.

BACKGROUND: Over the years schools have reduced physical education and recess time in favor of more academic instruction. Due to the drastic rise in obesity levels among children, some states have begun to mandate minimum amounts of physical activity (PA) that school children receive, causing schools to find alternative methods for increasing PA levels. Physical Activity Across the Curriculum (PAAC) is a 3-year randomized clinical trial incorporating moderate-intensity PA in elementary schools to reduce childhood obesity. This paper describes the rational, design, and methods of the PAAC intervention study. METHODS: Twenty-two elementary schools were randomized to either a control or intervention condition. In schools randomized to the intervention condition (PAAC), regular classroom teachers were taught how to incorporate PA into standard academic lessons. Teachers were asked to accumulate 90-100 min/week of PAAC each week through out the 3-year study period. Schools randomized to the control group did not alter their teaching methods. Direct observation of PA levels in the classroom was collected weekly. Height and weight was measured twice a year to calculate BMI. RESULTS: Two years of the intervention have been completed and only one school has left the study. The remaining 21 schools are participating in the final intervention year. CONCLUSIONS: The results from the PAAC intervention may provide schools with an alternative method to increase PA levels in children and reduce childhood obesity.

Statins and almonds to lower lipoproteins (the STALL Study).

BACKGROUND: Dietary supplementation with almonds has demonstrated dose-dependent decreases in low-density lipoprotein cholesterol (LDL-C), likely because of their composition of beneficial nutrients including mono- and polyunsaturated fatty acids, fiber, and protein. OBJECTIVE: The primary objective of this study was to determine the changes in the lipid profile (LDL-C, high-density lipoprotein cholesterol [HDL-C], triglycerides, total cholesterol, non-HDL-C), LDL-C particle size, and lipoprotein (a) when 100 g of almonds daily were added to background statin therapy for 4 weeks. METHODS: Subjects (N = 48) receiving a consistent statin dose were randomized to 100 g of almonds daily and to The National Cholesterol Education Program Adult Treatment Panel's third report Therapeutic Lifestyle Changes Diet counseling (almond group; n = 22) or solely Adult Treatment Panel's third report Therapeutic Lifestyle Changes Diet counseling (non-almond group; n = 26), for 4 weeks. RESULTS: No significant changes in weight and weekly physical activity were noted between the 2 groups from baseline. However, the almond group consumed significantly more calories at 4 weeks compared with controls. The almond group experienced a 4.9% reduction in non-HDL-C compared with a 3.5% increase for the non-almond group (P = .02). Additionally, notable improvements were observed in LDL-C and triglycerides, but did not achieve statistical significance (P = .068 for both parameters). There was also a shift from LDL pattern A to pattern B particles (P = .003) in the almond group. No significant differences in total cholesterol (P = .1), HDL-C (P = .3), or lipoprotein (a) (P = .1) were observed. CONCLUSION: Adding 100 g of almonds daily to chronic statin therapy for 4 weeks significantly reduced non-HDL-C. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00603876.

Exercise plus n-3 fatty acids: additive effect on postprandial lipemia.

The purpose of this study was to examine changes in postprandial lipemia (PPL) in recreationally active males following aerobic exercise, omega-3 fatty acids (n-3FA) supplementation, and the combination of the two. PPL following a high-fat meal was measured in 10 recreationally active males (25 +/-1.5 years) under each of the following conditions: no exercise and no n-3 FA supplementation (control); exercise and no n-3FA supplementation (exercise); n-3FA supplementation and no exercise (n-3FA); and exercise and n-3 FA supplementation (combined). Blood was collected before the high-fat meal and at 2, 4, 6, and 8 hours after the meal to assess the PPL response. Supplementation consisted of 4.0 g of n-3FA per day for 5 weeks. Triglyceride (TG) peak response, the total area under the TG curve (TG-AUCT), and the incremental area under the TG curve (TG-AUCI) were used to define the PPL response. TG peak response was significantly reduced 38% by n-3FA supplementation and 50% by the combination of exercise and n-3FA supplementation. N-3FAs significantly reduced the TG-AUCT by 27% and by 42% when combined with exercise. When compared with the exercise trial, the TG-AUCT during the combined trial was significantly lower. Exercise, n-3FAs, and the combination significantly reduced the TG-AUCI by 40%, 42%, and 58%, respectively. These results suggest that the combination of exercise and n-3FA supplementation reduce PPL to a greater degree in recreationally active males when compared with the individual treatments.

Effects of omega-3 fatty acid supplementation and exercise on low-density lipoprotein and high-density lipoprotein subfractions.

The purpose of this study was to examine the effect of combining exercise with omega-3 fatty acids (n-3fa) supplementation on lipoprotein subfractions and associated enzymes. Subjects were 10 recreationally active males, aged 25 +/- 1.5 years (mean +/- SE), who supplemented n-3fa (60% eicosapentaenoic acid [EPA] and 40% docosahexaenoic [DHA]) at 4 g/d for 4 weeks. Before and after supplementation, subjects completed a 60-minute session of treadmill exercise at 60% Vo(2)max. Following a 24-hour diet and activity control period, blood was collected immediately before and after the exercise session to assess lipid variables: high-density lipoprotein cholesterol (HDL-C) and subfractions, low-density lipoprotein cholesterol (LDL-C) and subfractions and particle size, lecithin:cholesterol acyltransferase (LCAT) activity, and cholesterol ester transfer protein (CETP) activity. Supplementation with n-3fa alone increased total HDL-C and HDL(2)-C, while exercise alone increased total HDL-C, HDL(3)-C, and total LDL-C. LDL subfractions, particle size, and LCAT and CETP activities were not affected by supplementation. Combination treatment resulted in an additive effect for HDL(3)-C only and also increased LDL(1)-C versus baseline. LCAT and CETP activities were not affected by treatments. These results suggest that n-3fa supplementation or an exercise session each affect total HDL-C and subfractions but not LDL-C or subfractions. In addition, the combination of n-3fa and exercise may have additional effects on total HDL-C and LDL-C subfractions as compared to either treatment alone in active young men.

Neuroimaging studies of factors related to exercise: rationale and design of a 9 month trial.

The prevalence of obesity is high resulting from chronic imbalances between energy intake and expenditure. On the expenditure side, regular exercise is associated with health benefits, including enhanced brain function. The benefits of exercise are not immediate and require persistence to be realized. Brain regions associated with health-related decisions, such as whether or not to exercise or controlling the impulse to engage in immediately rewarding activities (e.g., sedentary behavior), include reward processing and cognitive control regions. A 9 month aerobic exercise study will be conducted in 180 sedentary adults (n = 90 healthy weight [BMI = 18.5 to 26.0 kg/m(2)]; n = 90 obese [BMI = 29.0 to 41.0 kg/m(2)) to examine the brain processes underlying reward processing and impulse control that may affect adherence in a new exercise regimen. The primary aim is to use functional magnetic resonance imaging (fMRI) to examine reward processing and impulse control among participants that adhere (exercise >80% of sessions) and those that do not adhere to a nine-month exercise intervention with secondary analyses comparing sedentary obese and sedentary healthy weight participants. Our results will provide valuable information characterizing brain activation underlying reward processing and impulse control in sedentary obese and healthy weight individuals. In addition, our results may identify brain activation predictors of adherence and success in the exercise program along with measuring the effects of exercise and improved fitness on brain activation.

Equivalent weight loss for weight management programs delivered by phone and clinic.

OBJECTIVE: Face-to-face (FTF) weight management is costly and presents barriers for individuals seeking treatment; thus, alternate delivery systems are needed. The objective of this study was to compare weight management delivered by FTF clinic or group conference calls (phone). DESIGN AND METHODS: Randomized equivalency trial in 295 overweight/obese men/women (BMI = 35.1±4.9, Age = 43.8±10.2, Minority = 39.8%). Weight loss (0-6 months) was achieved by reducing energy intake between 1,200 and 1,500 kcal/day and progressing physical activity (PA) to 300 min/week. Weight maintenance (7-18 months) provided adequate energy to maintain weight and continued 300 min/week of PA. Behavioral weight management strategies were delivered weekly for 6 months and gradually reduced during 7-18 months. A cost analysis provided a comparison of expenses between groups. RESULTS: Weight change from baseline to 6 months was -13.4 ± 6.7% and -12.3 ± 7.0% for FTF clinic and phone, respectively. Weight change from 6-18 months was 6.4 ± 7.0% and 6.4 ± 5.2%, for FTF clinic and phone, respectively. The cost to FTF participants was $789.58 more per person. CONCLUSIONS: Phone delivery provided equivalent weight loss and maintenance and reduced program cost. Ubiquitous access to phones provides a vast reach for this approach.

Weight loss can lead to resolution of gastroesophageal reflux disease symptoms: a prospective intervention trial.

OBJECTIVE: Weight gain is an important risk factor for gastroesophageal reflux disease (GERD); however, whether weight loss can lead to resolution of GERD symptoms is not clear. Our aim was to measure the impact of weight loss on GERD symptoms. DESIGN AND METHODS: In a prospective cohort study at a tertiary referral center, overweight/obese subjects (BMI 25-39.9 kg/m2) were enrolled in a structured weight loss program. Weight loss strategies included dietary modifications, increased physical activity and behavioral changes. At baseline and at 6 months, BMI and waist circumference were measured and all participants completed a validated reflux disease questionnaire. RESULTS: A total of 332 adult subjects, mean age 46 years and 66% women were prospectively enrolled. At baseline, the mean body weight, BMI, and waist circumference were 101 (±18) kg, 35 (±5) kg/m2 and 103 (±13) cm. At 6 months, majority of the subjects (97%) lost weight (average weight loss: 13 ± 7.7 kg) and as compared with baseline, there was a significant decrease in the overall prevalence of GERD (15 vs. 37%; P < 0.01) and the mean GERD symptom score (1.8 vs. 5.5; P < 0.01). Overall, 81% of the subjects had reduction in GERD symptom scores; 65% had complete resolution and 15% had partial resolution of reflux symptoms. There was a significant correlation between % body weight loss and reduction in GERD symptom scores (r = 0.17, P < 0.05). CONCLUSIONS: In conclusion, the overall prevalence of GERD symptoms is high (37%) in overweight and obese subjects. A structured weight loss program can lead to complete resolution of GERD symptoms in the majority of these subjects.

Improving weight maintenance using virtual reality (Second Life).

OBJECTIVE: Compare weight loss and maintenance between a face-to-face (FTF) weight management clinic and a clinic delivered via virtual reality (VR). METHODS: Participants were randomized to 3 months of weight loss with a weekly clinic delivered via FTF or VR and then 6 months' weight maintenance delivered with VR. Data were collected at baseline and 3 and 6 months for weight and process variables. Twenty overweight and obese individuals (31.1 ± 3.6 years of age; body mass index, 32.8 ± 5.1; 85% females; 20% minorities) responded to advertisement and met inclusion criteria. Diets (1,200-1,800 kcal/d) used prepackaged meals, fruits and vegetables, and physical activity (300 min/wk). RESULTS: Weight loss was significantly greater for FTF at 10.8% compared with 7.6% for VR (P < .05). However, weight maintenance was significantly greater for VR at 14.0% compared with 9.5% for FTF (P < .05). CONCLUSIONS AND IMPLICATIONS: Virtual reality compares favorably with FTF for weight loss and may facilitate greater weight maintenance.

Aerobic exercise alone results in clinically significant weight loss for men and women: midwest exercise trial 2.

UNLABELLED: Exercise is recommended by public health agencies for weight management; however, the role of exercise is generally considered secondary to energy restriction. Few studies exist that have verified completion of exercise, measured the energy expenditure of exercise, and prescribed exercise with equivalent energy expenditure across individuals and genders. OBJECTIVE: The objective of this study was to evaluate aerobic exercise, without energy restriction, on weight loss in sedentary overweight and obese men and women. DESIGN AND METHODS: This investigation was a randomized, controlled, efficacy trial in 141 overweight and obese participants (body mass index, 31.0 ± 4.6 kg/m(2) ; age 22.6 ± 3.9 years). Participants were randomized (2:2:1 ratio) to exercise at either 400 kcal/session or 600 kcal/session or to a nonexercise control. Exercise was supervised, 5 days/week, for 10 months. All participants were instructed to maintain usual ad libitum diets. Because of the efficacy design, completion of ≥90% of exercise sessions was an a priori definition of per protocol, and these participants were included in the analysis. RESULTS: Weight loss from baseline to 10 months for the 400 and 600 kcal/session groups was 3.9 ± 4.9 kg (4.3%) and 5.2 ± 5.6 kg (5.7%), respectively, compared with weight gain for controls of 0.5 ± 3.5 kg (0.5%) (P < 0.05). Differences for weight loss from baseline to 10 months between the exercise groups and differences between men and women within groups were not statistically significant. CONCLUSIONS: Supervised exercise, with equivalent energy expenditure, results in clinically significant weight loss with no significant difference between men and women.

Resistance training volume, energy balance and weight management: rationale and design of a 9 month trial.

The increased prevalence of obesity and the lack of treatment success both argue for the design and evaluation of strategies to prevent the development of overweight and obesity. To date, the role of resistance training (RT) in this regard is largely unexplored. RT may be effective for weight management as a result of increased fat-free mass (FFM), which may result in increased resting metabolic rate and increased physical activity energy expenditure. However, the literature relative to the efficacy of RT protocols recommended for healthy adults to alter the aforementioned parameters is inconsistent or inadequately evaluated. We will conduct a 9 month randomized controlled efficacy trial to compare changes in body composition (fat mass, FFM, % body fat) and energy balance in response to 2 volumes of RT (1 vs. 3 sets vs. non-exercise control) both at the completion of training (9 months) and 1 year later (body composition). This investigation will be conducted in a sample of healthy, normal and overweight, sedentary, young adult men and women; a group at high risk for development of overweight and obesity. Our results will provide information relative to the minimum volume of RT that may be associated with body weight/fat gain which may inform the development of guidelines for RT to prevent weight gain or to alter body composition.

A randomized, controlled, supervised, exercise trial in young overweight men and women: the Midwest Exercise Trial II (MET2).

We evaluated weight loss response to 16 months of supervised exercise (45 min/day, 5 days/week, 75% heart-rate-reserve) in sedentary, overweight/obese participants without energy restriction in the Midwest Exercise Trial (MET1). Results indicated men lost weight, women did not. The gender differences were associated with differences in the energy expenditure of exercise (EEEx) (men=667±116; women=439±88 kcal/session) when exercise was prescribed by frequency, intensity and duration. MET2 is a randomized control trial designed and powered to examine differences in weight loss and gender in response to EEEx for men and women of 400 or 600 kcal/session, 5 days/week, for 10 months without energy restriction. One hundred forty-one participants will be randomized to 1 of 2 exercise groups or a non-exercise control. EEEx will be verified by indirect calorimetry monthly during the intervention. This study will evaluate: (1) the weight change response to two levels of EEEx versus non-exercise control; (2) gender differences in weight response to two levels of EEEx; (3) potential compensatory changes in energy intake and/or daily physical activity that may explain the observed weight changes. Results from this study may impact how exercise is prescribed for weight loss and prevention of weight regain and may clarify if men and women differ in response to exercise.

Weight management by phone conference call: a comparison with a traditional face-to-face clinic. Rationale and design for a randomized equivalence trial.

State-of-the-art treatment for weight management consists of a behavioral intervention to facilitate decreased energy intake and increased physical activity. These interventions are typically delivered face-to-face (FTF) by a health educator to a small group of participants. There are numerous barriers to participation in FTF clinics including availability, scheduling, the expense and time required to travel to the clinic site, and possible need for dependent care. Weight management clinics delivered by conference call have the potential to diminish or eliminate these barriers. The conference call approach may also reduce burden on providers, who could conduct clinic groups from almost any location without the expenses associated with maintaining FTF clinic space. A randomized trial will be conducted in 395 overweight/obese adults (BMI 25-39.9 kg/m(2)) to determine if weight loss (6 months) and weight maintenance (12 months) are equivalent between weight management interventions utilizing behavioral strategies and pre-packaged meals delivered by either a conference call or the traditional FTF approach. The primary outcome, body weight, will be assessed at baseline, 6, 12 and 18 months. Secondary outcomes including waist circumference, energy and macronutrient intake, and physical activity and will be assessed on the same schedule. In addition, a cost analysis and extensive process evaluation will be completed.

Evaluation of an approach to weight loss in adults with intellectual or developmental disabilities.

Of 79 overweight adults with intellectual or developmental disabilities who participated in a weight loss intervention, 73 completed the 6-month diet phase. The emphasis in the intervention was consumption of high volume, low calorie foods and beverages, including meal-replacement shakes. Lower calorie frozen entrees were recommended to control portion size. A walking activity was encouraged. Participants attended monthly meetings in which a small amount of cash was exchanged for self-recorded intake and exercise records completed on picture-based forms. Average weight loss was 13.2 pounds (6.3%) of baseline weight at 6 months, with weight loss shown by 64 of the 73 individuals enrolled. Those completing a 6-month follow-up phase showed weight loss of 9.4% of baseline. Increased choice and control are discussed as possible contributors to individual success.